Why hire a doula?

Any woman who has had a baby can tell you, giving birth is one time when extra support can be a life-changer. That’s where doulas come in. Unlike midwives, doulas are not medical professionals and don’t physically deliver babies; they’re there solely to provide informational, emotional and physical support to women in pregnancy, throughout labor, and beyond. What a huge job, especially now that birth has become such a medicalized event in many cultures.Here are ten things you should know when deciding on a doula:

1) Have a doctor and a doula. Your doctor will be in and out of the room as you labor, but a doula will stay with you from the beginning and won’t leave until the baby is born, the placenta is delivered, and, if you’re going to be breastfeeding, the first latch is established. Doulas will also come to your home if you want to labor there for a while before heading to the hospital. To keep you comfortable during labor and delivery, your doula might massage key pressure points, apply warm compresses to your lower back or set you up in a hot shower to ease the pain of contractions. And when you (or your partner) become completely overwhelmed and exhausted, she will be your one-woman pep squad. 2) You're doctor will be grateful for the help. Talk to your OB/GYN as soon as possible about your plans to hire a doula. Many OB/GYNs see the benefits that doulas provide and encourage their presence in the delivery room.

3) Your doula won't be the third wheel.Unless your significant other is a midwife or OB/GYN, he or she isn’t going to know nearly as much about the birth process as your doula. Even if it’s your second or third time having a baby, there will likely come a time when your partner will probably feel overwhelmed. Your doula is there to guide both of you through the process. She can suggest specific ways your partner can help you, while respecting the intimacy of your experience together.

4) Get recommendations and read testimonials. The best way to find a doula is through word of mouth. Get a list from friends and friends of friends or from your midwife or doctor. Start with phone interviews. Ask potential doulas about their experience and training, how many births they’ve attended, and why they decided to be a doula.

5) Interview face-to-face to see if you click.This might seem obvious, but as you are going to be spending some very intimate time with your doula, it’s critical that you like her. Will you feel comfortable letting her see you naked, throwing up, crying, yelling, swearing — maybe even defecating? Ask your potential doula about her birth philosophy, her feelings about natural and medical births, and how active or laid-back she tends to be in the birth room. If she’s part of a doula practice, do some comparison shopping and ask to meet with one or two of her colleagues. Your partner should come with you to the interview, as he or she will be working closely with the doula, too. 6) Look at the going rates and what is being offered. The going rate for a doula varies widely, depending on location. In New York, Los Angeles, and San Francisco, seasoned certified doulas charge between $1200 and $2700 for pre-birth discussions and full-time labor and delivery help. Some doulas include postpartum support in their fee. All doulas-in-training need birth experience, and many are willing to attend births for free or for a nominal fee. Remember, these doulas have attended far fewer births and worked with far fewer families, doctors, and labor situations. Inquire about their full list of offerings.

7) Your doula is full of resources. Expecting moms can lean on their doulas for emotional support and valuable information and advice in the weeks leading up to the birth. This can be particularly helpful for first-time moms, uncertain about how to differentiate between, say, Braxton Hicks contractions and the real thing. 8) Your doula is there for you, no matter what. Unlike doctors and some midwives, doulas only schedule a few births a month. That means they’re almost guaranteed to be there for the big event. With many doctors and midwives working in group practices, it’s a relief to know there’ll be at least one expert at your birth who you have an ongoing relationship with.

9) You don't have to be shy around your doula. You can ask your doula to do anything you can think of to help you. Whether it’s a foot rub, lower back massage, grabbing your partner a coffee from the cafeteria, changing the CD, talking you through each contraction, advocating for your natural birth, or advocating on your behalf to get the anesthesiologist in the room this minute with your epidural, your doula is there for you. 10) She'll come to nurture and educate you after the birth. While labor doulas attend births, post-partum doulas support new mothers at home in the first few weeks. Some doulas provide both services. For a few precious hours each week, a post-partum doula can carry your newborn in a sling while you nap and shower, teach your husband how to change diapers, do the laundry, support with breastfeeding, supply local resources, and prepare you nourishing meals for your own recovery.

FAQ about doulas:

1. What is a birth doula? A birth doula is a person trained and experienced in childbirth who provides continuous physical, emotional and informational support to the mother before, during and just after childbirth. 2. Where does the word “doula” come from? The word “doula” comes from ancient Greek, meaning “Woman’s servant.” Throughout history and in much of the world today, a cadre of women support a woman through labor and birth, giving back rubs and providing continuous emotional support. Like their historical counterparts, DONA International birth doulas know how to help a woman in labor feel better. However, today’s doulas are much more diverse than their predecessors. DONA International membership includes men and women from a wide range of ages and cultural backgrounds. 3. What effects does the presence of a doula have on birth outcomes? Numerous clinical studies have found that a doula’s presence at birth:

reduces the requests for pain medication and epidurals, as well as the incidence of cesareans

4. What effects does the presence of a doula have on the mother? When a doula is present during and after childbirth, women report greater satisfaction with their birth experience, make more positive assessments of their babies, have fewer cesareans and requests for medical intervention, and less postpartum depression. 5. What effects do the presence of doulas have on babies? Studies have shown that babies born with doulas present tend to have shorter hospital stays with fewer admissions to special care nurseries, breastfeed more easily and have more affectionate mothers in the postpartum period. 6. How do doulas practice? Doulas practice in three ways: privately hired directly by clients, as hospital employees, and as volunteers in community or hospital programs. 7. Does a doula replace nursing staff? No. Doulas do not replace nurses or other medical staff. Doulas do not perform clinical or medical tasks such as taking blood pressure or temperature, monitoring fetal heart rate, doing vaginal examinations or providing postpartum clinical care. They are there to comfort and support the mother and to enhance communication between the mother and medical professionals. 8. Does a doula make decisions on my behalf? A doula does not make decisions for clients or intervene in their clinical care. She provides informational and emotional support, while respecting a woman’s decisions. 9. Will a doula make my partner feel unnecessary? No, a doula is supportive to both the mother and her partner, and plays a crucial role in helping a partner become involved in the birth to the extent he/she feels comfortable.